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• SENDER: Complrno Items 1 end ]when edditlonel cervices are dashed, end compkta Items 3 and 4. <br />Put Your eddren In the "RETURN TO" tpaca on Ma revarw side, Failure to do this will ptevetttthis <br />card from being returned to you. The velum racei fee will rovlde ou the name of the arson <br />delMtad to antl data f del M one a o Ow ng earv Ma are evB e. nauh <br />poatmeeler or see an a< ox eel for additional nrvicelel requested. <br />1. ~ Slrow to when dalhiwad, dew, and addressee's eddrew. Z. ~ Ratrleted DeIMry. <br />to: <br />3. ? <br />, <br />J <br />tlcla Addre <br />ssed 4. A,t;NCI <br />ha <br />~ <br />, <br />l <br />f <br />( <br />ti <br />~ C ~ q <br />I ~ ~ <br />y~ <br />b <br />f <br />l~;w: <br />I <br />;~. <br />l.vta-C10. <br />1-Vn I <br />4. <br />[~ Ty <br />s <br />f Serv <br />hx: <br />~ <br />. <br />. p <br />o <br />) <br />_ <br />~ ~,,,.7-~C ~ ~ 5r' 3 C.~ RaWswnd ®Imutad <br />~pRifld COD <br />I <br />(~ { LLJJ E,grrew Mall <br />1-~~L~-~--~Ut.t,W ~ ¢l V L~ ('S C / _ <br />V~ AlwaYe obtain eignatuw of addressee or <br /> agent end DATE DELIVERED. <br />.Sign ure -Address 8. Addressee's Address (ONLY if <br /> requested and fee prndJ <br />igneturo -Agent <br />X <br />7. Date of D.livary~ <br />~~ :_ . / , <br />PS Form 3871, Feb. 1986 <br />DOMESTIC RETURN RECEIPT <br /> P 169 876 479~~ <br />ma <br /> y., <br />RECEIPT FOR CERTIFIED (WAIL <br /> NO INSDRANCE COVERAGE PROVIDED <br /> NOi FOR INTERNATIONAL MAIL <br /> (See Reverse) rddu_ 6ro~ 73 ~ <br />~ Sent to ~ <br />0 <br /> Sir tan No.' <br />3 t~ ;~ <br />-' <br />m <br />O <br />P.O., Slate nd 21 Cod W <br />vj <br /> <br />a ~ <br />Postage S _a <br />i ~,.~ <br />~ <br />* Cenifled Fee <br /> 3 <br /> Speci li <br /> <br /> <br />Restricted Delivery Fee a <br />V <br />=-~ <br /> Return Receip In ? <br /> to whom and Date Deliveretl <br />~ Return receipt <br />m Dat <br />LL TOTAL Pos tl Fees ~, S 0 <br /> b m <br /> Postmark 7U/ t@8 <br />o oD <br />o <br /> a ~ <br />~ <br />E 0 w <br />LL 9 y15 <br />N <br />n <br />